Relieve Pain, Reduce Stress and Restore Wellbeing with Mindfulness for Health
Pain always seems worse at night. There is something about the silence that amplifies the suffering. Even after you’ve taken the maximum dose of painkillers, the aching soon returns with a vengeance. You want to do something, anything, to stop the pain, but whatever you try seems to fail. Moving hurts. Doing nothing hurts. Ignoring it hurts. But it’s not just the pain that hurts; your mind can start to suffer as you desperately try to find a way of escaping. Pointed and bitter questions can begin nagging at your soul: What will happen if I don’t recover? What if it gets worse? I can’t cope with this . . . Please, I just want it to stop …
We wrote Mindfulness for Health to help you cope with pain, illness and stress in times such as these. It will teach you how to reduce your suffering progressively, so that you can begin living life to the full once again. It may not completely eliminate your suffering, but it will ensure that it no longer dominates your life. You’ll discover that it is possible to be at peace, even if illness and pain are unavoidable, and to enjoy a truly fulfilling life.
We know this to be true because we have both experienced terrible injuries and used an ancient form of meditation known as ‘mindfulness’ to ease our suffering. The techniques in this book have been proven to work by doctors and scientists in universities around the world. In fact, mindfulness is so effective that doctors and specialist pain clinics now refer their patients to our Breathworks centre in Manchester and to courses run by our affiliated trainers around the world. Every day we help people find peace amid their suffering.
Mindfulness for Health and its accompanying CD reveal a series of simple practices that you can incorporate into daily life to significantly reduce your pain, anguish and stress. They are built on Mindfulness-Based Pain Management (MBPM), which has its roots in the ground-breaking work of Dr Jon Kabat-Zinn of the University of Massachusetts Medical Center in America. The MBPM programme itself was developed by Vidyamala Burch (co-author of Mindfulness for Health book) as a means of coping with the after-effects of two serious accidents. Although originally designed to reduce physical pain and suffering, it has proven to be an effective stress-reduction technique as well. In fact, the core mindfulness meditation techniques have been shown in many clinical trials to be at least as effective as drugs or counselling for relieving anxiety, stress and depression. When it comes to pain, clinical trials show that mindfulness can be as effective as the main prescription painkillers, and some studies have shown it to be as powerful as morphine. Imaging studies show that it soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself so that you no longer feel pain with the same intensity. And when it does arise, the pain no longer dominates your life so much. Many people report that their pain declines to such a degree that they barely notice it at all.
Many hospital pain clinics now prescribe mindfulness meditation to help patients cope with the suffering arising from a wide range of diseases such as cancer (and the side effects of chemotherapy), heart disease, diabetes and arthritis. It is also used for back problems, migraine, fibromyalgia, coeliac disease, and a range of auto-immune diseases such as lupus and multiple sclerosis, as well as being effective for such long-term conditions as chronic fatigue syndrome and irritable bowel syndrome. It’s also useful for coping with labour pain. In addition to all these uses, clinical trials also show that mindfulness significantly reduces the anxiety, stress, depression, irritability and insomnia that can arise from chronic pain and illness. Researchers are continually finding new conditions that can be eased with mindfulness.
Mindfulness Dissolves Pain and Suffering
Mindfulness-Based Pain Management uses ancient meditations that were largely unknown in the West until recently. A typical meditation involves focusing on the breath as it flows into and out of the body (see box, below). This allows you to see your mind and body in action, to observe painful sensations as they arise and to let go of struggling with them. Mindfulness teaches you that pain naturally waxes and wanes. You learn to gently observe it, rather than be caught up in it, and when you do so, something remarkable happens: it begins to melt away of its own accord. After a while you come to the profound realisation that pain comes in two forms: Primary and Secondary. Each of these has very different causes – and understanding this gives you far greater control over your suffering.
Primary pain tends to arise from illness, injury or damage to the body or nervous system. You could see it as raw information being sent by the body to the brain. Secondary pain follows on close behind, but is often far more powerful and distressing. Secondary pain can be seen as the mind’s reaction to Primary pain.
Pain’s volume control
The mind has tremendous control over the sensations of pain that you consciously feel and how unpleasant they are. It has a ‘volume’ control that governs both the intensity and duration of the sensations of pain. This is because your mind does not simply feel pain, it also processes the information that it contains. It teases apart all of the different sensations to try to find their underlying causes so that you can avoid further pain or damage to the body. In effect, your mind zooms in on your pain for a closer look as it tries to find a solution to your suffering. This ‘zooming-in’ amplifies your pain. As your mind analyses the pain, it also sifts through your memories for occasions when you have suffered similarly in the past. It is searching for a pattern, some clues, that will lead to a solution. Trouble is, if you have suffered from pain or illness for months or years, then the mind will have a rich tapestry of painful memories on which to draw – but very few solutions. So before you know it, your mind can become flooded with unsettling memories. You can become enmeshed in thoughts about your suffering. It can seem as if you’ve always been ill and in pain, that you’ve never found a solution and that you never will. So you can end up being consumed by future anxieties, stresses and worries as well as physical pain: What will happen if I can’t stop this pain? Am I going to spend my life suffering like this? Is it going to keep on getting worse?
This process happens in an instant, before you’re consciously aware of it. Each thought builds on the last and quickly turns into a vicious cycle that ends up further amplifying your pain. And it can be worse than this because such stresses and fears feed back into the body to create even more tension and stress. This can aggravate illnesses and injuries, leading to even more pain. It also dampens down the immune system, so impairing healing. So you can all too easily become trapped in a vicious downward spiral that leads to ever greater suffering.
But even worse, such negative spirals can begin wearing tracks in the mind so that you become primed to suffer. Your brain begins fine-tuning itself to sense pain more quickly – and with greater intensity – in a futile bid to try to avoid the worst of it. Over time, the brain actually becomes better at sensing pain. Brain scans confirm that people who suffer from chronic pain have more brain tissue dedicated to feeling the conscious sensations of pain. It’s almost as if the brain has turned up the volume to maximum and doesn’t know how to turn it down again.
It’s important to emphasise that Secondary pain is real. You do genuinely feel it. It’s only called Secondary pain because it is the mind’s reaction to Primary pain and has been heavily processed before you consciously feel it. But this same processing also gives you a way out; it means you can learn to gain control over your pain. For this reason, Secondary pain is best described as suffering.
In practice, you can be in pain but you need not suffer. Once you realise this, deep in your heart, then you can learn to step aside from your suffering and begin to handle pain very differently indeed. In effect, mindfulness hands back to you the volume control for your pain.
The benefits of mindfulness on overall mental and physical health have been demonstrated in a wide range of scientific studies. Despite this, you might still be a little sceptical about meditation. When the word is mentioned a whole cascade of stereotypes can spring to mind: Buddhist monks, yoga classes, lentils, brown rice . . . So, before we proceed, we’d like to dispel some myths:
• Mindfulness is not a religion. It is simply a form of mental training that has been proven in countless scientific trials to help people cope with pain, illness, anxiety, stress, depression, irritability and exhaustion.
• Meditation will not trick you into passivity or resign you to your fate. On the contrary, mindfulness boosts mental and physical resilience.
• Meditation will not seduce you into adopting a fake ‘positive’ attitude to life. It simply creates a form of mental clarity that helps you to enjoy life and achieve your goals.
• Meditation does not take a lot of time. The programme in our book takes around twenty minutes per day. In fact, many people find that it liberates more time than it consumes because they spend far less time having to cope with chronic pain, illness and stress.
• Meditation is not difficult or complicated, although it does require some effort and persistence. You can meditate on more or less anything (we even include a Coffee Meditation in our book). You can also do it virtually anywhere – on buses, trains, aircraft or even in the busiest office.
MINDFULNESS FOR HEALTH
Our book operates on two levels, which unfold week by week. The core mindfulness programme takes eight weeks and there is a chapter dedicated to each step. Each week you’ll be asked to carry out two meditations on six days out of seven. These take just ten minutes each.
You’ll also be encouraged to break some of your unconscious habits of thinking and behaving. These can embed a surprising amount of suffering because much of what we think and feel is locked in place by ongoing ways of approaching the world. By simply breaking some of your more ingrained habits you will help dissolve away your suffering. Habit-breaking – we prefer the term ‘habit-releasing’ – is straightforward. It can be as simple as watching the clouds from a park bench or waiting for the kettle to fully boil before making a cup of tea or coffee (rather than rushing to switch it off).
The programme in our book is best carried out over the recommended eight weeks, although you can do it over a longer period if you wish. Many people find that mindfulness gives them so many benefits that they continue with it for the rest of their lives. They see it as a journey that continuously reveals their true potential.
It can be a long and fruitful journey. We wish you well.
The Benefits of Mindfulness Meditation
Thousands of peer-reviewed scientific papers prove that mindfulness enhances mental and physical wellbeing and reduces chronic pain. Clinical trials show that mindfulness is at least as effective as the main prescription painkillers while also enhancing the body’s natural healing systems.
Here are a few of the main proven benefits of mindfulness meditation:
• Anxiety, stress, depression, exhaustion and irritability all decrease with regular sessions of meditation.1 Memory improves, reaction times become faster and mental and physical stamina increase.2 In short, regular meditators are happier and more contented, while being far less likely to suffer from psychological distress.15
• Mindfulness can dramatically reduce pain and the emotional reaction to it.5,6 Recent trials suggest that average pain ‘unpleasantness’ levels can be reduced by 57 per cent while accomplished meditators report reductions of up to 93 per cent.7
• Clinical trials show that mindfulness improves mood and quality of life in chronic pain conditions such as fibromyalgia8 and lower-back pain,9 in chronic functional disorders such as IBS,10 and in challenging medical illnesses, including multiple sclerosis11 and cancer.12
• Mindfulness improves working memory, creativity, attention span and reaction speeds. It also enhances mental and physical stamina and resilience.13
• Meditation improves emotional intelligence.14
• Mindfulness is at least as good as drugs or counselling for the treatment of clinical-level depression. One structured programme known as Mindfulness-Based Cognitive Therapy (MBCT) is now one of the preferred treatments recommended by the UK’s National Institute for Health and Clinical Excellence.16
• Mindfulness reduces addictive and self-destructive behaviour. These include the abuse of illegal and prescription drugs and excessive alcohol intake.17
• Meditation enhances brain function. It increases grey matter in areas associated with self-awareness, empathy, self-control and attention.18 It soothes the parts of the brain that produce stress hormones19 and builds those areas that lift mood and promote learning.20 It even reduces some of the thinning of certain areas of the brain that naturally occurs with ageing.21
• Meditation improves the immune system. Regular meditators are admitted to hospital far less often for cancer, heart disease and numerous infectious diseases.22
• Mindfulness may reduce ageing at the cellular level by promoting chromosomal health and resilience.23
•Meditation and mindfulness improve control of blood sugar in type II diabetes.24
• Meditation improves heart and circulatory health by reducing blood pressure and lowering the risk of hypertension. Mindfulness reduces the risks of developing and dying from cardiovascular disease and lowers its severity should it arise.25
A Simple Breath-based Meditation
Meditation can be simple and does not require any special equipment. The meditation below demonstrates the basic technique and takes just a few minutes. It will leave you profoundly relaxed.
1. If your condition allows it, sit erect but relaxed in a straight- backed chair with your feet flat on the floor. If you cannot sit, then lie on a mat or blanket on the floor, or on your bed. Allow your arms and hands to be as relaxed as possible.
2. Gently close your eyes and focus your awareness on the breath as it flows into and out of your body. Feel the sensations the air makes as it flows in through your mouth or nose, down your throat and into your lungs. Feel the expansion and subsiding of your chest and belly as you breathe. Focus your awareness on where the sensations are strongest. Stay in contact with each in-breath and each out-breath. Observe it without trying to alter it in any way or expecting anything special to happen.
3. When your mind wanders, gently shepherd it back to the breath. Try not to criticise yourself. Minds wander. It’s what they do. The act of realising that your mind has wandered – and encouraging it to return to focus on the breath – is central to the practice of mindfulness.
4. Your mind may eventually become calm – or it may not. If it becomes calm, then this may only be short-lived. Your mind may become filled with thoughts or powerful emotions such as fear, anger, stress or love. These may also be fleeting. Whatever happens, simply observe as best you can without reacting to your experience or trying to change anything. Gently return your awareness back to the sensations of the breath again and again.
5. After a few minutes, or longer if you prefer, gently open your eyes and take in your surroundings.
1 Baer, R. A., Smith, G. T., Hopkins, J., Kreitemeyer, J. & Toney, L. (2006), ‘Using self-report assessment methods to explore facets of mindfulness’, Assessment, 13, pp. 27–45.
2 Jha, A., et al. (2007), ‘Mindfulness training modifies subsystems of attention’, Cognitive Affective and Behavioral Neuroscience, 7, pp. 109–19; Tang, Y. Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q., et al. (2007), ‘Short-term meditation training improves attention and self-regulation’, Proceedings of the National Academy of Sciences (US), 104(43), pp. 17152–6; McCracken, L. M. & Yang, S.-Y. (2008), ‘A contextual cognitive-behavioral analysis of rehabilitation workers’ health and well-being: Influences of acceptance, mindful- ness and values-based action’, Rehabilitation Psychology, 53, pp.479–85; Ortner, C. N. M., Kilner, S. J. & Zelazo, P. D. (2007), ‘Mindfulness meditation and reduced emotional interference on a cognitive task’, Motivation and Emotion, 31, pp. 271–83; Brefczynski-Lewis, J. A., Lutz, A., Schaefer, H. S., Levinson, D. B. & Davidson, R. J. (2007), ‘Neural correlates of attentional expert- ise in long-term meditation practitioners’, Proceedings of the National Academy of Sciences (US), 104(27), pp. 11483–8.
3. Brown, Christopher A., Jones, Anthony K. P., (2013) ‘Psychobiological Correlates of Improved Mental Health in Patients With Musculo- skeletal Pain After a Mindfulness-based Pain Management Program’, Clinical Journal of Pain, 29(3), pp. 233–44.
4. Zeidan, F., Martucci, K. T., Kraft, R. A., Gordon, N. S., McHaffie, J. G. & Coghill, R. C. 2011, ‘Brain Mechanisms Supporting the Modu- lation of Pain by Mindfulness Meditation’, Journal of Neuroscience, 31(14), p. 5540. See also the accompanying comments regarding mor- phine effectiveness by Fadel Zeidan of the Wake Forest University School of Medicine at http://ow.ly/i8rZs.
5. Kabat-Zinn, J., Lipworth, L., Burncy, R. & Sellers, W. (1986), ‘Four- year follow-up of a meditation-based program for the self- regulation of chronic pain: Treatment outcomes and compliance’, Clinical Journal of Pain, 2, p. 159; Morone, N. E., Greco, C. M. & Weiner, D. K. (2008), ‘Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study’, Pain, 134(3), pp. 310–19; Grant, J. A. & Rainville, P. (2009), ‘Pain sensitivity and analgesic effects of mindful states in zen medi- tators: A cross-sectional study’, Psychosomatic Medicine, 71(1), pp. 106–14.
6. Brown, Christopher A., Jones, Anthony K. P. 2013, MD, ‘Psycho- biological Correlates of Improved Mental Health in Patients With Musculoskeletal Pain After a Mindfulness-based Pain Management Program’, Clinical Journal of Pain, 29(3), pp. 233–44.
7. Zeidan, F., Martucci, K. T., Kraft, R. A., Gordon, N. S., McHaffie, J. G. & Coghill, R. C. 2011, ‘Brain Mechanisms Supporting the Modulation of Pain by Mindfulness Meditation’, Journal of Neuro- science, 31(14), p. 5540. See also the accompanying comments regarding morphine effectiveness by Fadel Zeidan of the Wake Forest University School of Medicine at http://ow.ly/i8rZs.
8. Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A. & Kesper, U. (2007), ‘Mindfulness training as an intervention for fibromyalgia: evidence of postintervention and 3-year follow-up benefits in well-being’, Psychotherapy and Psychosomatics, 76, pp. 226–233; Sephton, S. E., Salmon, P., Weissbecker, I., Ulmer, C., Floyd, A., Hoover, K., et al. (2007), ‘Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial’, Arthritis & Rheumatism, 57, pp. 77–85; Schmidt, S., Grossman, P., Schwarzer, B., Jena, S., Naumann, J., and Walach, H. (2011), ‘Treating fibromyalgia with mindfulness-based stress reduction: results from a 3- armed randomized controlled trial’, Pain 152, pp. 361–9.
9. Morone, N. E., Lynch, C. S., Greco, C. M., Tindle, H. A. & Weiner, D. K. (2008b), ‘“I felt like a new person” – the effects of mindfulness med- itation on older adults with chronic pain: qualitative narrative analysis of diary entries’, Journal of Pain, 9, pp. 841–8.
10. Gaylord, S. A., Palsson, O. S., Garland, E. L., Faurot, K. R., Coble, R. S., Mann, J. D., et al. (2011), ‘Mindfulness training reduces the sever- ity of irritable bowel syndrome in women: results of a randomized controlled trial’, American Journal of Gastroenterology, 106, pp. 1678–88.
11. Grossman, P., Kappos, L., Gensicke, H., D’souza, M., Mohr, D. C., Penner, I. K., et al. (2010), ‘MS quality of life, depression, and fatigue improve after mindfulness training: a randomized trial’, Neurology, 75, pp. 1141–9.
12. Speca, M., Carlson, L., Goodey, E. & Angen, M. (2000), ‘A random- ized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients’, Psychosomatic Medicine, 62, pp. 613–22.
13. Jha, A., et al. (2007), ‘Mindfulness training modifies subsystems of attention’, Cognitive Affective and Behavioral Neuroscience, 7, pp. 109–19; Tang, Y. Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q., et al. (2007), ‘Short-term meditation training improves attention and self- regulation’, Proceedings of the National Academy of Sciences (US), 104(43), pp. 17152–6. McCracken, L. M. & Yang, S.-Y. (2008), ‘A contextual cognitive-behavioral analysis of rehabilitation workers’ health and well-being: Influences of acceptance, mindfulness and values-based action’, Rehabilitation Psychology, 53, pp.479–85; Ortner, C. N. M., Kilner, S. J. & Zelazo, P. D. (2007), ‘Mindfulness meditation and reduced emotional interference on a cognitive task’, Motivation and Emotion, 31, pp. 271–83; Brefczynski-Lewis, J. A., Lutz, A., Schaefer, H. S., Levinson, D. B. & Davidson, R. J. (2007), ‘Neural correlates of attentional expertise in long-term meditation practitioners’, Proceedings of the National Academy of Sciences (US), 104(27), pp. 11483–8.
14. Brown, Kirk Warren, Ryan, Richard, M. (2003), ‘The benefits of being present: Mindfulness and its role in psychological well-being’, Journal of Personality and Social Psychology, 84(4), pp. 822–48; Lykins, Emily L. B. & Baer, Ruth A. (2009), ‘Psychological Functioning in a Sample of Long-Term Practitioners of Mindfulness Meditation’, Journal of Cognitive Psychotherapy, 23(3), pp. 226–41.
15. Ivanowski, B. & Malhi, G. S. (2007), ‘The psychological and neuro- physiological concomitants of mindfulness forms of meditation’, Acta Neuropsychiatrica, 19, pp. 76–91; Shapiro, S. L., Oman, D., Thoresen, C. E., Plante, T. G. & Flinders, T. (2008), ‘Cultivating mindfulness: effects on well-being’, Journal of Clinical Psychology, 64(7), pp. 840–62; Shapiro, S. L., Schwartz, G. E. & Bonner, G. (1998), ‘Effects of mindfulness-based stress reduction on medical and pre- medical students’, Journal of Behavioral Medicine, 21, pp. 581–99.
16. See NICE Guidelines for Management of Depression (2004, 2009). Ma, J. & Teasdale, J. D. (2004), ‘Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse preven- tion effects’, Journal of Consulting and Clinical Psychology, 72, pp. 31–40; Segal, Z. V., Williams, J. M. G. & Teasdale, J. D., Mindfulness-based Cognitive Therapy for Depression: a new approach to preventing relapse (Guilford Press, 2002); Kenny, M. A. & Williams, J. M. G. (2007), ‘Treatment-resistant depressed patients show a good response to Mindfulness-Based Cognitive Therapy’, Behaviour Research & Therapy, 45, pp. 617–25; Eisendraeth, S. J., Delucchi, K., Bitner, R., Fenimore, P., Smit, M. & McLane, M. (2008), ‘Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression: A Pilot Study’, Psychotherapy and Psychosomatics, 77, pp. 319–20; Kingston, T., et al. (2007), ‘Mindfulness-based cognitive therapy for residual depressive symptoms’, Psychology and Psychotherapy, 80, pp. 193–203.
17. Bowen, S., et al. (2006), ‘Mindfulness Meditation and Substance Use in an Incarcerated Population’, Psychology of Addictive Behaviors, 20, pp. 343–7.
18. Hölzel, B. K., Ott, U., Gard, T., Hempel, H., Weygandt, M., Morgen, K. & Vaitl, D. (2008), ‘Investigation of mindfulness meditation prac- titioners with voxel-based morphometry’, Social Cognitive and Affective Neuroscience, 3, pp 55–61; Lazar, S., Kerr, C., Wasserman, R., Gray, J., Greve, D., Treadway, M., McGarvey, M., Quinn, B., Dusek, J., Benson, H., Rauch, S., Moore, C. & Fischl, B. (2005), ‘Meditation experience is associated with increased cortical thickness’, NeuroReport, 16, pp. 1893–7; Luders, Eileen, Toga, Arthur W., Lepore, Natasha & Gaser, Christian (2009), ‘The underlying anatom- ical correlates of long-term meditation: Larger hippocampal and frontal volumes of gray matter’, Neuroimage, 45, pp. 672–8.
19. Tang, Y., Ma, Y., Wang, J., Fan, Y., Feg, S., Lu, Q., Yu, Q., Sui, D., Rothbart, M., Fan, M. & Posner, M. (2007), ‘Short-term meditation training improves attention and self-regulation’, Proceedings of the National Academy of Sciences, 104, pp. 17152–6.
20. Davidson, R. J. (2004), ‘Well-being and affective style: Neural sub- strates and biobehavioural correlates’, Philosophical Transactions of the Royal Society, 359, pp. 1395–1411.
21. Lazar, S., Kerr, C., Wasserman, R., Gray, J., Greve, D., Treadway, M., McGarvey, M., Quinn, B., Dusek, J., Benson, J., Rauch, S., Moore, C. & Fischl, B. (2005), ‘Meditation experience is associated with increased cortical thickness’, NeuroReport, 16, pp 1893–7.
22. Davidson, R. J., Kabat-Zinn, J. Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S.F., Urbanowski, F., Harrington, A., Bonus, K. & Sheridan, J. F. (2003) ‘Alterations in brain and immune function produced by mindfulness meditation’, Psychosomatic Medicine, 65, pp. 564–70; Tang, Y., Ma, Y., Wang, J., Fan, Y., Feg, S., Lu, Q., Yu, Q., Sui, D., Rothbart, M., Fan, M. & Posner, M. (2007), ‘Short-term med- itation training improves attention and self-regulation’, Proceedings of the National Academy of Sciences, 104, pp. 17152–6.
23. Epel, Elissa, Daubenmier, Jennifer, Tedlie Moskowitz, Judith, Folkman, Susan & Blackburn, Elizabeth (2009), ‘Can Meditation Slow Rate of Cellular Aging? Cognitive Stress, Mindfulness, and Telomeres’, Annals of the New York Academy of Sciences, 1172; Longevity, Regeneration, and Optimal Health Integrating Eastern and Western Perspectives, pp. 34–53.
24. Walsh, R. & Shapiro, S. L. (2006), ‘The meeting of meditative disci- plines and Western psychology: A mutually enriching dialogue’, American Psychologist, 61, pp. 227–39.
25. Ibid. 26. Kabat-Zinn, J., Lipworth, L., Burncy, R. & Sellers, W. (1986), ‘Four-year follow-up of a meditation-based program for the self- regulation of chronic pain: Treatment outcomes and compliance’, Clinical Journal of Pain, 2, p. 159; Brown, Christopher A., Jones, Anthony K. P. (2013), ‘Psychobiological Correlates of Improved Mental Health in Patients With Musculoskeletal Pain After a Mindfulness-based Pain Management Program’, Clinical Journal of Pain, 29(3), pp. 233–44; Lutz, Antoine, McFarlin, Daniel R., Perlman, David M., Salomons, Tim V. & Davidson, Richard J. (2013), ‘Altered anterior insula acti- vation during anticipation and experience of painful stimuli in expert meditators’, Journal NeuroImage, 64, pp. 538–46.
27.Baliki, Marwan N., Bogdan, Petre, Torbey, Souraya, Herrmann, Kristina M., Huang, Leijan, Schnitzer, Thomas J., Fields, Howard L. &, Vania Apkarian, A. (2012), ‘Corticostriatal functional connectivity predicts transition to chronic back pain’, Nature Neuroscience, 15, pp. 1117–19.